Prevalence of hearing loss, tinnitus, vertigo and sudden deafness among patients with polymyositis and dermatomyositis.

Little is known about a possible association of autoimmune inner ear disease among patients diagnosed with polymyositis (PM)/dermatomyositis (DM). This study aimed to explore differences in the prevalence of inner ear symptoms among patients with and without PM/DM using a nationwide population-based dataset. Data for this study were retrieved from the Taiwan National Health Insurance Research Database. The study sample included 1622 patients diagnosed with PM/DM and 8109 propensity-score matched comparison patients without PM/DM. We performed multivariate logistic regressions to calculate odds ratios (ORs) and 95% confidence interval (CI) for tinnitus, hearing loss, sudden deafness, and vertigo among patients with PM/DM versus comparison patients. Chi-square tests showed statistically significant differences between patients with PM/DM and comparison patients in the prevalence of tinnitus (16.1% vs. 12.7%, p < 0.001), non-conductive hearing loss (9.2% vs. 6.8%, p < 0.001), and vertigo (14.4% vs. 11.1%, p < 0.001). The adjusted ORs for tinnitus, non-conductive hearing loss, and vertigo, respectively, were 1.332 (95% CI = 1.147-1.547), 1.399 (95% CI = 1.154-1.696), and 1.374 (95% CI = 1.173-1.611) for patients with PM/DM when compared to comparison patients. Our study finds that patients with PM/DM have higher prevalence rates of tinnitus, non-conductive hearing loss, and vertigo than comparison patients.

Peripheral vertigo and subsequent risk of depression and anxiety disorders: a prospective cohort study using the UK Biobank.

BACKGROUND: Peripheral vertigo is often comorbid with psychiatric disorders. However, no longitudinal study has quantified the association between peripheral vertigo and risk of psychiatric disorders. Furthermore, it remains unknown how the white matter integrity of frontal-limbic network relates to the putative peripheral vertigo-psychiatric disorder link. METHODS: We conducted a cohort study including 452,053 participants of the UK Biobank with a follow-up from 2006 through 2021. We assessed the risks of depression and anxiety disorders in relation to a hospitalization episode involving peripheral vertigo using Cox proportional hazards models. We also examined the associations of peripheral vertigo, depression, and anxiety with MRI fractional anisotropy (FA) in a subsample with brain MRI data (N = 36,087), using multivariable linear regression. RESULTS: Individuals with an inpatient diagnosis of peripheral vertigo had elevated risks of incident depression (hazard ratio (HR) 2.18; 95% confidence interval (CI) 1.79-2.67) and anxiety (HR 2.11; 95% CI 1.71-2.61), compared to others, particularly within 2 years after hospitalization (HR for depression 2.91; 95% CI 2.04-4.15; HR for anxiety 4.92; 95% CI 3.62-6.69). Depression was associated with lower FA in most studied white matter regions, whereas anxiety and peripheral vertigo did not show statistically significant associations with FA. CONCLUSIONS: Individuals with an inpatient diagnosis of peripheral vertigo have increased subsequent risks of depression and anxiety disorders, especially within 2 years after hospitalization. Our findings further indicate a link between depression and lower microstructural connectivity as well as integrity beyond the frontal-limbic network.

Ten-year incidence, predictors and impact of dizziness and vertigo in community-dwelling adults.

OBJECTIVES: We used a cohort of community-dwelling adults to establish the 10-year incidence and predictors of dizziness/vertigo, and its impacts on health-related quality of life. STUDY DESIGN: Of the 1152 participants aged 55 + years who did not have dizziness/vertigo at baseline, 799 and 377 participants were followed up after 5 and 10 years, respectively, and had complete data and so were included in the incidence analysis. Hearing loss was determined as the pure-tone average of audiometric hearing thresholds at 500, 1000, 2000 and 4000 Hz, and any hearing loss was defined as >25 dB hearing level. Tinnitus and migraine were assessed by a positive response to a single question. MAIN OUTCOME MEASURES: Audiologists screened participants for reported dizziness using a single question. Quality of life was measured using the Short Form 36-item Health Survey (SF-36). RESULTS: The cumulative 10-year incidence of dizziness/vertigo, vestibular vertigo and non-vestibular vertigo were 39.8 %, 27.1 %, and 11.9 %, respectively. Age and presence of migraine were significant predictors of incident dizziness/vertigo: multivariable-adjusted hazard ratio (HR) 1.03 (95 % confidence interval, CI, 1.01-1.06) and HR 1.63 (95 % CI 1.13-2.35), respectively. A significant decrease in scores for the following SF-36 domains was observed over the 10 years among participants reporting baseline dizziness/vertigo: physical functioning (P-trend ≤ 0.0001), role limitation due to physical problems (P-trend ≤ 0.0001), general health (P-trend = 0.01), and vitality (P-trend = 0.01). CONCLUSIONS: Dizziness/vertigo was a frequent and detrimental symptom in this population of community-dwelling adults. Our study highlights the burden imposed by dizziness, as evidenced by a significant prospective association with poorer quality of life.

Dizziness and vertigo in patients with tension-type headache: A case-control study.

BACKGROUND: A few studies have demonstrated dizziness and vertigo in patients with tension-type headache (TTH). However, the prevalence and other characteristics of vestibular symptoms in TTH has not been studied in a systemic manner so far. The aim of the study was to see the prevalence of vestibular symptoms in patients with tension-type headache as compared with controls. METHODS: This case-control study included 100 TTH patients and 100 controls who do not have significant history of headaches. RESULTS: Vestibular symptoms (Vertigo, dizziness, vestibulovisual or postural symptom) were experienced by 25% of patients with TTH and 10% in the control group (Odd Ratio = 3.0 [95% CI, 1.4-6.6], P = .006). The vestibular symptoms were statistically more in patients with chronic tension-type headache (CTTH) than episodic TTH (67% vs 9%. 9, P5 = < 0.005). Hospital Anxiety and Depression score (HAD-A and HAD-D) scores in patients with TTH with vestibular symptoms were significantly higher than TTH without vestibular symptoms- HAD-A (5.1 ± 1.7 vs 4.0 ± 1.5, P = 0.002) and HAD-D(5.8 ± 2.1 vs 4.2 ± 1.9, P = < 0.001). Phonophobia was also more frequent in TTH patients with vertigo (42% vs.13%, P5 = 0.005). CONCLUSION: Vestibular symptoms may be more common in patients TTH than control. The prevalence of vestibular symptoms depends on the frequency of TTH.

Predictive Factors for Subjective Vertigo Following Cochlear Implantation: A Regional Multicenter Cohort Study of 395 Patients.

INTRODUCTION: Cochlear implantation (CI) is generally accepted as having a low rate of postoperative complications, but between 9.3% and 13% of cases experience vertigo postoperatively. This study aimed to examine patient, surgical, and device factors contributing toward the risk of postoperative vertigo. METHODOLOGY: A retrospective review was conducted of adult patients who underwent cochlear implant in a regional area of New South Wales from 2007 to 2018. A total of 395 cochlear implant cases were included in the final study. RESULTS: The overall incidence of vertigo at 3 months of follow-up was 7.1% (n = 28/395). No difference was identified in this study between rates of postoperative vertigo between device factors, including implant make (Cochlear vs. Med-El), electrode shape (perimodiolar vs. straight), and electrode model. No significant difference was found also for surgical factors such as the number of electrode rings inserted, side of implantation, or surgical approach of tympanic ramp (round window insertion vs. cochleostomy).A higher percentage of patients with preoperative vertigo experienced vertigo postoperatively (18.4%, n = 7/38), compared with the population without preoperative vertigo (6.0%, n = 21/352) ( p = 0.005). Patients with previous mastoid surgery also reported a higher rate of postoperative vertigo (20%, n = 9/45) compared with those who had not had mastoid surgery (5.43%, n = 19/350) ( p = 0.006). The mean age of patients experiencing postoperative vertigo was higher than the population without postoperative symptoms (67 vs. 63). CONCLUSION: This study of a large multicenter population outlines that patient factors are more critical than surgical or device factors when considering risk factors for vertigo post-cochlear implant.

The TriAGe + score for vertigo or dizziness: A validation study in a university hospital emergency department in Hong Kong.

OBJECTIVE: Patients with dizziness commonly present to Emergency Departments (ED) and 6% of these patients will be diagnosed with acute stroke. The TriAGe+ score comprises of eight clinical parameters and stratifies patients into four risk groups. The Japanese authors reported that the tool performed well, so our aim was to validate this diagnostic tool in our ED in Hong Kong. MATERIALS AND METHODS: A single-center retrospective observational study was conducted in the ED of our university hospital in Hong Kong. The primary outcome was the diagnosis of an acute cerebrovascular event. Receiver operator characteristic (ROC) analysis was performed to determine the best cut-off score. Secondary outcomes included univariable and multivariable analyses of stroke predictors. RESULTS: 455 patients aged 18 years or above with dizziness or vertigo at ED triage were recruited between 19 July and 30 September 2021. The overall prevalence of stroke was 11.9%. The median TriAGe+ score was 7 (IQR = 4-9). The AUC was 0.9. At a cut-off >5, sensitivity was 96.4% (95%CI: 87.3-99.5) and the negative likelihood ratio was 0.09 (95%CI: 0.02-0.3). At a cut-off >10, specificity was 99.8% (95%CI: 98.6-100.0), and the positive likelihood ratio was 237.6 (95%CI: 33.1-1704). On multivariable analyses, atrial fibrillation, blood pressure, gender, dizziness (not vertigo) and no history of dizziness, vertigo or labyrinth/vestibular disease were found to be positively associated with stroke outcomes significantly. CONCLUSION: The TriAGe+ score is an efficient stroke prediction score for patients presenting to the ED with dizziness.

Benign paroxysmal vertigo of childhood.

Benign paroxysmal vertigo of childhood (or recurrent vertigo of childhood) is the most common cause of vertigo in young children. It is considered a pediatric migraine variant or precursor disorder, and children with the condition have an increased likelihood of developing migraine later in life than the general population. Episodes are typically associated with room-spinning vertigo in conjunction with other migrainous symptoms (e.g. pallor, nausea, etc.), but it is rarely associated with headaches. Episodes typically only last for a few minutes and occur with a frequency of days to weeks without interictal symptoms or exam/test abnormalities. Treatment is rarely necessary, but migraine therapy may be beneficial in cases where episodes are particularly severe, frequent, and/or prolonged. An appreciation of the typical presentation and characteristics of this common condition is essential to any provider responsible for the care of children with migraine disorders and/or dizziness. This chapter will review the current literature on this condition, including its proposed pathophysiology, clinical presentation, and management. This chapter also includes a brief introduction to pediatric vestibular disorders, including relevant anatomy, physiology, embryology/development, history-taking, physical examination, testing, and a review of other common causes of pediatric dizziness/vertigo.

A Comparison Study of Nutritional Assessment, Diet and Physical Activity Habits, Lifestyle and Socio-Demographic Characteristics in Individuals with and without Dizziness/Vertigo.

Dizziness and vertigo are growing health problems and have become responsible for increases in health expenditures. In this context, a case-control study has been conducted by nutritional assessment, including dietary and physical activity habits, lifestyle, and socio-demographic characteristics in adults with (patient group) and without (control group) dizziness or vertigo, and the outcomes were compared between these groups. The patient (n = 150) and control (n = 150) groups included 300 participants. The 24-h Dietary Recall and the food frequency questionnaire (FFQ-21) were conducted in order to gain detailed information about foods and beverages consumed by the participants. Additionally, a questionnaire was completed, assessing general socio-demographic (age, gender, etc.) and lifestyle (smoking, alcohol consumption, and obesity) characteristics, anthropometric measurements, and dietary and physical activity habits. The results revealed that there is an association between dizziness/vertigo and female gender and increasing age. Smoking status and alcohol consumption did not differ between the groups, whereas differences in body mass index and obesity were significantly higher in the patient group (65%; n = 98) than the control group (46%; n = 69) (p = 0.001). Skipping meals "everyday" was significantly high (p = 0.044), and lunch was the most skipped meal in the patient group. The three most preferred cooking methods were oven baking, boiling, and frying for both groups. Daily water intake in the patient group was lower than in the control group (p = 0.026). Dietary intake for carotene and vitamin K were significantly lower in the patient group than the control group, but the opposite was true for vitamin D intake (p < 0.05). Daily consumption of bread and dairy products were highest in the patient group (p < 0.05). The physical activity rate was 35% (n = 53) in the control group and 28% (n = 42) in the patient group. Regular walking was the most preferred activity in both groups (p = 0.037). Active monitoring of individual diet and hydration along with supporting professional counseling are advisable. In addition, a healthy lifestyle including weight control and regular physical activity can be helpful to reduce symptoms of dizziness/vertigo.

Self-reported dizziness, falls, and self-rated health in a rural population in Denmark.

PURPOSE: To investigate associations between dizziness, hearing loss, medication, and self-perceived health in the region of Lolland-Falster in Denmark. METHODS: A cross-sectional population-based study using data from questionnaires and physical examinations between February 8th, 2016, and February 13th, 2020. Individuals aged 50 years or above in the region of Lolland-Falster were randomly invited to participate. RESULTS: Of 10,092 individuals (52% female), the mean age was 64.7 and 65.7 years for females and males, respectively. 20% reported dizziness during the past 30 days, and prevalence increased with age. 24% of dizzy females suffered from falls compared to 21% of males. 43% sought treatment for dizziness. Logistic regression revealed a higher odds ratio of dizziness in groups with poor self-perceived health (OR = 2.15, 95% CI [1.71, 2.72]) and very poor self-perceived health (OR = 3.62 [1.75, 7.93]) compared to moderate self-perceived health. A higher OR was found for seeking treatment for dizziness in the group that had experienced falls (OR = 3.21 [2.54, 4.07]). 40% reported hearing loss. Logistic regression revealed a higher OR for dizziness in the group with severe hearing loss (OR = 2.40 [1.77, 3.26]) and moderate hearing loss (OR = 1.63 [1.37, 1.94]) compared to no hearing loss. CONCLUSION: One of five participants reported dizziness during the last month. Dizziness was negatively associated with self-perception of good health also after adjusting for comorbidities. Almost half of the dizzy participants sought treatment for dizziness and 21% experienced falls. Identification and treatment of dizziness are important to prevent falls from happening. CLINICAL TRIAL REGISTRATION: http://www. CLINICALTRIALS: gov (NCT02482896).

Vertigo and Dizziness After Coronavirus Disease-2019 Vaccination: A Nationwide Analysis.

BACKGROUND: Side effects occurring after COVID-19 vaccination can include vertigo and dizziness. Despite its high incidence, few studies to date have assessed dizziness/vertigo after vaccination. The present study investigated the incidence of dizziness/vertigo after COVID-19 vaccination in South Korea. METHODS: Adverse reactions to COVID-19 vaccination reported to the Korea Disease Control and Prevention Agency from February 26, 2021, to July 31, 2022 (week 74) were analyzed. The incidence rates of dizziness/vertigo in subjects vaccinated with 5 COVID-19 vaccines, AZD1222 (AstraZeneca), BNT162b2 (Pfizer-BioNTech), JNJ-78436735 (Janssen), mRNA-1273 (Moderna), and NVX-CoV2373 (Novavax), were determined. RESULTS: A total of 126 725 952 doses of COVID-19 vaccine were administered, with 473 755 suspected adverse reactions (374 per 100 000 vaccinations) reported. Vertigo/dizziness was reported after the administration of 68 759 doses, or 54.3 per 100 000 vaccinations, making it the third most common adverse reaction after headache and muscle pain. CONCLUSION: Dizziness/vertigo was generally a mild adverse reaction after COVID-19 vaccination, but it was the third most common adverse reaction in Korea. Studies are necessary to clarify the causal relationship between vaccination and dizziness/vertigo and to prepare subjects for this possible adverse reaction.

Vértigo en gestantes: presentación clínica, impacto en la calidad de vida y factores asociados / Vertigo in pregnancy: clinical presentation, impact on quality of life and associated factors

OBJETIVO: Evaluar las características clínicas, el impacto en la calidad de vida y los factores asociados con vértigo en gestantes hospitalizadas en una institución de alta complejidad. MÉTODO: Estudio transversal. Se realizó una encuesta dirigida a la presencia de vértigo y sus características clínicas en 2020-2021. La calidad de vida se evaluó con el cuestionario Dizziness Handicap Inventory (DHI). El análisis estadístico incluyó un modelo lineal generalizado. RESULTADOS: De 103 mujeres, el 19,4% indicaron vértigo principalmente en el segundo trimestre de gestación (60%), con una mediana de 3,5 (rango intercuartil: 1,5-7,5) episodios. Fueron referidos vértigos episódicos asociados con cambios posicionales (40%), acompañados de inestabilidad (60%), cefalea (60%), fotopsias (55%) y tinnitus (45%). Las mujeres con vértigo presentaron mayor frecuencia de discapacidad moderada a grave en las dimensiones del DHI emocional (30 vs. 2,4%; p = 0,001), funcional (40 vs. 2,4%; p < 0,001) y física (55 vs. 2,4%; p < 0,001) en comparación con las mujeres sin la patología. La hospitalización durante el embarazo Razón de proporción (RP): 4,02; intervalo de confianza del 95% [IC95%]: 1,64-9,85; p = 0,002) y la presencia de vértigo pregestacional (RP: 2,37; IC95%: 1,15-4,88; p = 0,019) se identificaron como factores asociados. CONCLUSIONES: La alta frecuencia de vértigo en las gestantes sugiere la importancia de estudiar esta condición durante el embarazo, para lograr un manejo integral y generar acciones de prevención y control efectivas.

OBJECTIVE: To evaluate clinical characteristics, impact on quality of life and factors associated with vertigo in pregnant women hospitalized in a highly complex institution. METHOD: A cross-sectional study was conducted in 2021-2022. One focused survey including Dizziness Handicap Inventory (DHI) was performed. The statistical analysis was performed using a generalized lineal regression. RESULTS: 103 patients were included, 19.4% indicated vertigo mostly during the second semester (60%). A median of 3.5 episodes was obtained (RIC: 1.5-7.5). Positional and episodic vertigos (40%) associated with unsteadiness (60%), headache (60%), photopsia (55%) and tinnitus (45%) were described. DHI in pregnant females with vertigo compared to those without vertigo, presented higher rates of moderate to severe disability in the emotional (30 vs. 2.4%: p = 0.001), functional (40 vs. 2.4%; p < 0.001) and physical (55 vs. 2.4%; p < 0.001) dimensions. Hospitalizations during the pregnancy (RP: 4.02; 95%CI: 1.64-9.85; p = 0.002) and previous episodes before pregnancy (RP: 2.37; 95%CI: 1.15-4.88; p = 0.019) were identified as associated factors with current vertigo episodes. CONCLUSIONS: The high frequency of vertigo in pregnant women suggests the importance of studying this condition during pregnancy, to achieve comprehensive management and generate effective prevention and control actions.

Vertiginous dizziness: A primary care approach.

Dizziness is an extremely common, yet complex neurological symptom that reflects a disturbance of normal balance perception and spatial orientation. Dizziness is a non-specific, catch-all term commonly used by patients to describe a wide array of symptoms, including a sensation of motion, weakness, light-headedness, unsteadiness, emotional upset and depression. The national 1-year prevalence of dizziness is around 50%, accounting for 4% of emergency department presentations and 1% of primary care consultations in South Africa. This article will focus on a diagnostic approach to the most common cause of dizziness (vertigo).

Vestibular Vertigo and Disparities in Healthcare Access Among Adults in the United States.

OBJECTIVE: Vertigo and dizziness have a high lifetime prevalence with significant impacts on daily life. We sought to explore differences in access to and ability to afford care among adults with vestibular vertigo by race/ethnicity, income, and insurance type. DESIGN: This is a cross-sectional study using the 2016 National Health Interview Survey. A total of 32,047 adults who completed the 2016 National Health Interview Survey Balance Supplement were analyzed. We used a previously validated definition of vertigo defined as (1) positional vertigo, (2) rotational vertigo, or (3) recurrent dizziness with nausea and either oscillopsia or imbalance. We examined several self-reported measures of healthcare utilization and access. RESULTS: Among adults with vestibular vertigo, African Americans had significantly increased odds of delayed care due to lack of transportation; Hispanic ethnicity was associated with decreased odds of skipping medication doses and asking a doctor for a lower-cost medication. Adults with public insurance had significantly lower odds of reporting delayed care due to worry about cost, not receiving medical care due to cost, and delayed filling of a prescription, but had greater odds of reporting delayed care due to lack of transportation. Lack of insurance and lower income were associated with increased odds of delaying and not receiving care due to cost. CONCLUSION: These findings demonstrate significant differences in access to care among adults with vestibular vertigo in the United States based on race, income, and health insurance status.

Acute effects of ambient air pollution on daily neurology clinic visits for vertigo: a time-series study in Wuhan, China.

This study aimed to disclose the relationship between ambient air pollution and neurology clinic visits (NCVs) for vertigo. A time-series study was conducted to examine relationships between six different criteria air pollutants (SO2, NO2, PM2.5, PM10, CO, and O3) and daily NCVs for vertigo in Wuhan, China, from January 1st, 2017 to November 30th, 2019. Stratified analyses were computed according to gender, age, and season. A total of 14,749 records of NCVs for vertigo were enrolled in this study. Data showed that the increase in daily NCVs for vertigo corresponding to 10 µg/m3 increase of respective pollutants are: SO2 (- 7.60%; 95% CI: - 14.25 to - 0.44%), NO2 (3.14%; 95% CI: 0.23 to 6.13%), PM2.5 (0.53%; 95% CI: - 0.66 to 1.74%), PM10 (1.32%; 95% CI: - 0.36 to 3.06%), CO (0.00%; 95% CI: - 0.12 to 0.13%), and O3 (0.90%; 95% CI: - 0.01% to 1.83%). Males were more susceptible to acute exposure to SO2 and NO2, compared to females (SO2: - 11.91% vs. - 4.16%; NO2: 3.95% vs. 2.92%), whereas the acute effect of O3 exposure was more significantly obvious in females than males (0.94% vs. 0.87%). Moreover, correlations between daily NCVs for vertigo and acute exposure to SO2, NO2, and O3 were all stronger in individuals under 50 years old (SO2: - 12.75% vs. - 4.41%; NO2: 4.55% vs. 2.75%; O3: 1.27% vs. 0.70%). Short-term exposure to PM2.5 was more significantly associated with daily NCVs for vertigo in cool seasons (1.62% vs. - 0.68%), while the correlation between CO exposure and daily NCVs for vertigo was stronger in warm seasons (0.21% vs. - 0.03%). Our study demonstrated acute exposure to ambient NO2 and O3 positively associated with daily NCVs for vertigo. Acute effects of air pollution on daily NCVs for vertigo varied according to gender, age, and season.

Prevalence of vestibular migraine in an otolaryngologic clinic: Preliminary clinical diagnosis versus diagnosis according to the strictly applied Bárány criteria.

BACKGROUND: Diagnostic criteria of vestibular migraine (VM) by the Bárány classification consists of complex combinations of characteristics of dizziness: episodes, intensity, duration, migraine according to International Classification of Headache Disorders (ICHD), and migraine features accompanying vertigo. The prevalence according to strictly applied Bárány criteria may be much lower than preliminary clincal diagnosis. OBJECTIVE: The purpose of this study is to investigate the prevalence of VM according to strictly applied Bárány criteria among dizzy patients who visited the otolaryngology department. METHODS: The medical records of patients with dizziness from December 2018 to November 2020 were retrospectively searched using a clinical big data system. The patients completed a questionnaire designed to identify VM according to Bárány classification. Microsoft Excel function formulas were used to identify cases that met the criteria. RESULTS: During the study period, 955 new patients visited the otolaryngology department complaining of dizziness, of which 11.6% were assessed as preliminary clinical diagnosis of VM in outpatient clinic. However, VM according to strictly applied Bárány criteria accounted for only 2.9% of dizzy patients. CONCLUSION: The prevalence of VM according to strictly applied Bárány criteria could be significantly lower than that of preliminary clinical diagnosis in outpatient clinic.

Prevalence of self-reported middle ear disease, hearing loss and vertigo in two adult population-based cohorts over a 20-year period in Greenland.

To estimate the frequencies of self-reported middle ear and hearing complaints and vertigo/dizziness in adult Greenlanders. Furthermore, to examine if there has been a development in the frequency of these complaints within a 20-year period. A structured questionnaire concerning middle ear disease and related neuro-otological symptoms was mailed to 400 randomly selected adult Greenlanders between 18 and 60 years of age in 1995. In 2014, the questions were included for the same age group in the general Greenlandic Health Survey. The questionnaires contained a total of six identical questions. In 1995, 281 participants (70%) replied to the questionnaire. In 2014, 1,639 participants (78%) replied. We found that in 1995 the two youngest age groups (18-29- and 30-39-year-olds) had the highest relative number of ear discharge. Approximately one-third of the participants in these two age groups reported to have had ear discharge, while this was only reported by 17% of the 18-29-year-olds and 16% of the 30-39-year-olds in 2014 (95% CI [0.03, 0.3] and [0.1, 0.3], respectively). The oldest age group indicated the lowest relative number of experiences of ear discharge in both 1995 and 2014 (18% and 17%, respectively). In 1995, 30% in the age group 30-39-year-olds reported hearing loss, whereas only 18% reported hearing loss in 2014 (p < 0.05, 95% CI [-0.003,0.2]). There was no significant difference in reported ear discharge since childhood and otitis media in childhood among the age groups between 1995 and 2014. However, in 1995 significantly more females had experienced ear discharge in the age groups 18-29 and 30-39 year-olds compared to 2014. Females in the age group 18-29 year-olds also showed a significant difference in having experienced otitis media in childhood, where 32% answered "yes" in 1995, and 18% answered "yes" in 2014 (p < 0.05). In 2014, females reported more frequent complaints of vertigo compared to males, 16% and 9%, respectively (p < 0.05). In 1995, there was no significant difference in experienced vertigo between males and females. Ear and hearing health problems and vertigo are reported frequently in the Greenlandic population. Overall, a tendency of less complaints in 2014 compared to 1995 except for vertigo. It is important to follow this trend and increase the prophylactic efforts to reduce common health disabilities like early otitis media in childhood and noise created symptoms even more.

Epidemiology of patients with dizziness over a 3-year period, requiring utilization of the emergency medical serviced system: A pre- and post-COVID pandemic comparative study using the population-based ORION registry.

OBJECTIVE: We aimed to identify the proportion of each medical condition or disease contributing to dizziness and their disposition in the Emergency Department (ED). METHODS: This retrospective, descriptive study examined data from the Osaka Emergency Information Research Intelligent Operation Network system in Japan for the period from January 1, 2018 to December 31, 2020. The inclusion criteria were patients with presumptive ICD-10 codes including "dizziness" or "vertigo". Patient demographics were compared using the χ2 test and Kruskal-Wallis test. Logistic regression analysis was performed to calculate disposition from ED (emergency admission or discharge) over the 3-year study period. The adjusted odds ratio (OR) and 95% confidence interval (CI) were calculated using multivariate analyses. RESULTS: During the 3-year study period, a total of 1,346,457 patients (462,773 in 2018, 468,697 in 2019, and 414,987 in 2020; P < 0.001), including 53,190 patients with dizziness (18,396 in 2018, 18,649 in 2019, and 16,145 in 2020; P = 0.058), were identified as having been transported to hospitals by ambulance in Osaka Prefecture. Dizziness and giddiness (R42) was the most common form of dizziness, in 27,075 cases (9,570 in 2018, 9,613 in 2019, and 7,892 in 2020; P < 0.001; Gender composition showed 10,483 males and 16,592 females.) Vestibular Neuronitis (H81.2) showed significant increase in 2020 compared to the two preceding years (91 in 2018, 119 in 2019, and 130 in 2020, P = 0.003; including 174 males and 167 females, respectively). Of the 53,190 patients with dizziness, 11,862 (22.3%; 4,323 males, 7,539 females) were admitted to hospital. The odds ratio (OR) for emergency admission for dizziness in 2020 during the COVID-19 pandemic was 0.98 (95% confidence interval (CI), 0.93- 1.03) with reference to 2018. CONCLUSION: Patients with dizziness accounted approximately 4% of ED transportations, with about 20% requiring hospital admission, irrespective of the COVID-19 pandemic. Vestibular neuronitis was significantly increased in 2020.

Prevalence and consequences of concurrent dizziness on disability and quality of life in patients with long-lasting neck pain.

PURPOSE: The purpose of this study was to examine the prevalence of concurrent dizziness in patients seeking treatment for neck pain at a secondary care clinic and examine how dizziness associates with physical function, disability, quality of life, and duration of neck pain. METHODS: This was a cross-sectional study where patients referred for neck pain (n = 133) were recruited from an outpatient spine clinic and divided into: patients with and without dizziness. All patients were examined with posturography, global body examination-flexibility and cervical range of motion, and completed the Neck Disability Index (NDI) and RAND-12 health survey. Patients with concurrent dizziness completed the Vertigo Symptom Scale short form (VSSsf). RESULTS: Forty-three percent of the patients reported dizziness. Concurrent dizziness was associated with increased postural sway with eyes open (p < .001), eyes closed (p = .024), eyes open on foam (p = .010), eyes closed on foam (p = .003), higher disability on the NDI (ß: 2.9, p = .009), RAND-12 physical (ß: -4.3, p = .014) and mental subscales (ß: -4.0, p = .014). A higher score on NDI was associated with higher score on the VSSsf (total score: r = 0.51, p < .001, anxiety: r = 0.52, p < .001, vertigo: r = 0.43, p = .02.). CONCLUSION: Dizziness is common among patients with long-lasting neck pain. It is associated with higher disability due to neck symptoms and general health-related quality of life. The findings highlight the importance of evaluating and addressing dizziness in patients with neck disorders.

Influence of the Electrode Array Design on Incidence of Vertigo Symptoms and Vestibular Function After Cochlear Implantation.

PURPOSE: To evaluate if a specific type of cochlear implant (CI) electrode array (EA) reveals higher rates/prevalence of vestibular symptoms and to characterize their respective relationship to intracochlear position and objective vestibular function. METHODS: This retrospective study included 71 cochlear implantations in patients older than 18 years. The electrode position within the cochlea, electrode insertion angle, and cochlear coverage were determined from postoperative multiplanar reconstructed cone-beam computed tomography scans. All device manufacturers were represented. Data related to preoperative and postoperative PTA as well as vestibular symptoms in the preoperative and postoperative stages were collected from the patient's records. RESULTS: Twelve of the 71 (16.9%) CI patients experienced vertigo symptoms in the early postoperative period. In 5 (7.0%) patients, the vertigo complaints lasted until the time of the first activation (5-6 weeks postoperative). Postoperative onset of vestibular symptoms was more often seen in patients receiving lateral wall (LW)/straight EAs (19%) compared to perimodiolar/precurved EAs (7%), but this was only a trend and no statistical significance was observed. Moreover, preoperative pathologic caloric responses (CRs) better predicted the postoperative onset of vestibular symptoms. CONCLUSION: The preoperative consideration of a complicated CI-induced vertigo is important in the counseling particularly of elderly patients. We identified some risk factors for post-CI vertigo that should be considered in the patient's counseling: preoperative pathologic CRs, the extent of surgical trauma, and possibly the use of an LW EA, regardless of the length.

Risk factors of vestibular migraine-related brain white matter lesions.

OBJECTIVE AND PURPOSE: Migraine is related to white matter lesions (WMLs), and attack frequency and duration in migraine patients are thought to increase WMLs. However, the relationship between vestibular migraine (VM) and WMLs remains unclear. This study explored the risk factors for WMLs in VM patients and provided a basis for the prevention of WMLs in VM patients. METHODS: A large single-center cross-sectional study of patients with VM was conducted. None of the patients had comorbidities, such as hypertension and diabetes, or adverse lifestyle habits (smoking and drinking). All patients were divided into WML + and WML- groups after assessment of WMLs using magnetic resonance imaging (MRI). After collecting the patient's detailed medical history, statistical analysis was performed. RESULTS: In univariate analysis, the frequency of vertigo was statistically significant between the WML + and WML- groups. However, there was no significant difference in other clinical features. Multivariate regression analysis found that the frequency of vertigo (OR 2.399; 95% CI 1.014-5.679; p = 0.046) was an independent risk factor for WMLs. High frequency of vertigo episodes showed more pronounced risk factors (OR 9.607; 95% CI 1.061-87.014; p = 0.044). CONCLUSION: These results substantiate that vertigo frequency is an independent risk factor for WMLs in VM. A high frequency of vertigo episodes is more likely to be associated with WMLs than a low frequency. These results suggest a possible approach to the prevention of WMLs in VM patients.